EFFECT OF ABDOMINAL MASSAGE ON GASTRIC RESIDUAL VOLUME AMONG CRITICALLY ILL PATIENTS AT CAIRO UNIVERSITY HOSPITALS
Hanaa Ali Ahmed El-Feky - Assistant Professor, Critical Care and Emergency Nursing, Faculty of Nursing, Cairo University, Egypt
Nahla Shaaban Ali - Assistant Professor, Critical Care and Emergency Nursing, Faculty of Nursing, Cairo University, Egypt
ABSTRACT
Background: Prevention and management of food intolerance in critically ill patients receiving enteral nutrition represent important nursing consideration. These require utilizing techniques and methods for increasing the rate of gastric emptying, and so enhancing tolerance to this nutritional support modality. Among these methods is abdominal massage which has been proved to improve various digestive functions through its direct effect on gastric residual (an important determinant of enteral feeding tolerance). However few studies have been conducted in critical care units and in some studies, contradictory findings have been recorded. Aim of the study: to investigate the effect of 15- minute abdominal massage on aspirated the gastric residual volume (GRV) in critically ill patients in three consecutive days. A quasi experimental research design was adopted in this study. A purposive sample consisting of 60 adult critically ill patients divided into two matched and equal groups (study and control) was recruited. The intervention (abdominal massage) was provided for the studied group three times per day for 15 minutes, over a period of three consecutive days. The aspirated gastric residual volume was measured before abdominal massage and 3 hour after the massage each assessment time. Results: the present study revealed reduction in the mean GRV among the studied group in the second as compared to the first assessment time all over the three days, with significant statistical differences between the two assessment times (before and after feeding) in the first and second assessment days (t = 19.17+18.76 & 9.33+ 10.8; and t = 11.5+8.82 & 5.17+6.36 respectively at p<0.05). The mean GRV decreased in the third day's second assessment as compared to the first assessment (t =3.67+6.55 & t =4.43+7.02 respectively at p< 0.437) with no significant difference. Concerning, the control group, their mean second assessment GRV increased as compared to the first one in the first and second days (28.5+13.96 & 32.33+11.98 and 33.17+14.05 &37.5+13.8, at p< 0.005 respectively); in the third day, the mean second assessment GRV reduced as compared to the first assessment (30.17+13.9 & 25.33+7.8, at p<0.005 respectively). Comparisons between the study and control groups mean GRV showed high significant statistical differences in the three assessment days. Conclusion Application of a 15 minutes abdominal massage is a successful nursing intervention. It showed significant reduction GRV in adult critically ill patients receiving enteral nutrition. Recommendations: Abdominal massage must be incorporated in nursing management of critically ill patients receiving enteral nutrition.
